- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,323.00 / $9,544.15 / $20,928.72
| Facility | | $3,323.00 | $9,544.15 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,009.30 / $3,958.05 / $7,656.16
| Facility | | $3,009.30 | $3,958.05 | $7,656.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,387.40 / $1,387.40 / $1,387.40
| Facility | | $1,387.40 | $1,387.40 | $1,387.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $636.26 / $1,145.27 / $3,253.20
| Facility | | $636.26 | $1,145.27 | $3,253.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,271.00 / $1,553.00 / $2,046.55
| Facility | | $1,271.00 | $1,553.00 | $2,046.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |